Palacios Huatuco René M, Ramírez Mariano F, Stoppani Ignacio, Mendoza Santos Horacio, Mayer Horacio F
Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA). 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina.
Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA). 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina.
Int J Surg Case Rep. 2023 Mar;104:107967. doi: 10.1016/j.ijscr.2023.107967. Epub 2023 Mar 7.
Soft tissue metastases from any primary malignant tumor are considered very rare and can be found in subcutaneous or muscle tissue. We present the fifth case of breast cancer (BC) metastasis in subcutaneous tissue of the back and with an interval of 15 years between its detection and the diagnosis of BC.
A 57-year-old woman with a history of left mastectomy with axillary lymphadenectomy and immediate breast reconstruction due to invasive ductal BC with positive hormone receptors and HER2 negative 15 years ago. She consulted for a mass on her back and elevated levels of CA15-3. Nuclear magnetic resonance showed a tumor in the subcutaneous tissue in contact with the muscular aponeurosis. Radical metastasectomy was performed with curative intent and intraoperative control of the margins by freezing. Histopathology and immunohistochemistry reported a lesion consistent with breast adenocarcinoma metastasis, with positive estrogen and progesterone receptors, positive GATA-3, negative HER2, and free margins. The patient is free of disease 4 years after surgery.
The incidence of soft tissue metastasis of breast cancer is 0.2-0.8 %. To date, only four cases of BC metastasis in the subcutaneous tissue of the back have been reported. This is the case with the longest relapse time reported in the literature.
Soft tissue metastases should be suspected in all patients with a history of breast cancer, even 15 years after diagnosis.
任何原发性恶性肿瘤的软组织转移都被认为非常罕见，可发生于皮下或肌肉组织。我们报告了第五例乳腺癌转移至背部皮下组织的病例，从发现转移灶到乳腺癌诊断间隔了15年。
一名57岁女性，15年前因激素受体阳性、HER2阴性的浸润性导管癌行左侧乳房切除术及腋窝淋巴结清扫术，并即刻进行了乳房重建。她因背部肿物及CA15-3水平升高前来就诊。核磁共振显示皮下组织有一个与肌腱膜相连的肿瘤。行根治性转移灶切除术，术中通过冷冻控制切缘。组织病理学和免疫组化报告显示病变符合乳腺腺癌转移，雌激素和孕激素受体阳性，GATA-3阳性，HER2阴性，切缘阴性。患者术后4年无疾病复发。
乳腺癌软组织转移的发生率为0.2%-0.8%。迄今为止，仅报道了4例乳腺癌转移至背部皮下组织的病例。这是文献报道中复发时间最长的病例。
所有有乳腺癌病史的患者，即使在诊断后15年，也应怀疑有软组织转移。
